Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika

Abstract Objectives To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. Methods A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. Results Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. Conclusions Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible.

Cochlear radiation dose and hearing loss in patients with vestibular schwannoma undergoing radiosurgery: systematic review

Abstract Objectives: To determine the cut-off point of the cochlear radiation dose as a risk factor for hearing loss in patients with vestibular schwannoma treated with radiosurgery. Methods: A systematic review of the literature was performed without language or publication year restrictions in the MEDLINE/PubMed, EMBASE, Web of Science, LILACS/VHL and Cochrane Library databases. Studies that met the following criteria were included: 1) population: adults of both sexes who underwent radiosurgery for vestibular schwannoma treatment; 2) exposure: cochlear radiation; 3) outcome: hearing loss; 4) type of study: cohort. Two independent reviewers conducted the entire review process. The registration number in PROSPERO was CRD42020206128. Results: From the 333 articles identified in the searches, seven were included after applying the eligibility criteria. There was no standardization as to how to measure exposure or outcome in the included studies, and most studies did not present sufficient data to enable meta-analysis. Conclusion: It was not possible to determine a cut-off point for high cochlear dose that could be considered a risk factor for hearing loss.

Decompensated Heart Failure with Mid-Range Ejection Fraction: Epidemiology and In-Hospital Mortality Risk Factors

Abstract Background: Recently, a new HF entity, with LVEF between 40-49%, was presented to comprehend and seek better therapy for HF with preserved LVEF (HFpEF) and borderline, in the means that HF with reduced LVEF (HFrEF) already has well-defined therapy in the literature. Objective: To compare the clinical-therapeutic profile of patients with HF with mid-range LVEF (HFmrEF) with HFpEF and HFrEF and to verify predictors of hospital mortality. Method: Historical cohort of patients admitted with decompensated HF at a supplementary hospital in Recife/PE between April/2007 - August/2017, stratified by LVEF (< 40%/40 - 49/≥ 50%), based on the guideline of the European Society of Cardiology (ESC) 2016. The groups were compared and Logistic Regression was used to identify predictors of independent risk for in-hospital death. Results: A sample of 493 patients, most with HFrEF (43%), HFpEF (30%) and HFmrEF (26%). Average age of 73 (± 14) years, 59% men. Hospital mortality 14%, readmission within 30 days 19%. In therapeutics, it presented statistical significance among the 3 groups, spironolactone, in HFrEF patients. Hospital death and readmission within 30 days did not make difference. In the HFmrEF group, factors independently associated with death were: valve disease (OR: 4.17, CI: 1.01-9.13), altered urea at admission (OR: 6.18, CI: 1.78-11.45) and beta-blocker hospitalization (OR: 0.29, CI: 0.08-0.97). In HFrEF, predictors were: prior renal disease (OR: 2.84, CI: 1.19-6.79), beta-blocker at admission (OR: 0.29, CI: 0.12-0.72) and ACEI/ ARB (OR: 0.21, CI: 0.09-0.49). In HFpEF, only valve disease (OR: 4.61, CI: 1.33-15.96) and kidney disease (OR: 5.18, CI: 1.68-11.98) were relevant. Conclusion: In general, HFmrEF presented intermediate characteristics between HFrEF and HFpEF. Independent predictors of mortality may support risk stratification and management of this group.

Pediatric medicines and their relationship to dental caries / Medicamentos infantis e sua relação com cárie dentária

The aim of this study was to evaluate mothers' knowledge about the cariogenic potential of pediatric medicines. A total of 111 mothers were interviewed using a standardized form containing 15 questions relating to the association of pediatric drug use with dental caries and oral hygiene care. Descriptive and inferential statistics (Chi-square test and Fisher's exact) were used at a significance of 5 percent. Most of the mothers were aged 40 years or under (77.4 percent), high school educated (30.6 percent) and not working (50.5 percent). The association between medication use and dental caries or defects in teeth structure was mentioned by 35 (43.2 percent) mothers, 33 of whom (40.7 percent) cited this was due to the presence of sugar in the formulations. Only 32 mothers (28.8 percent) performed oral hygiene for the child after drugs ingestion, although 81.1 percent (n = 90) had never received guidance on the importance of this practice. The type of occupation and maternal education level were not significant in these issues (p> 0.05). Pediatric medicines can create problems for the teeth and a high percentage of mothers are unable to establish a clear cause and effect relationship with this association. Therefore, the pharmaceutical industry needs to be more aware of this and should prepare pediatric medicines without the presence of sucrose.

O objetivo do estudo foi verificar o conhecimento materno sobre o potencial cariogênico de medicamentos infantis. Foram entrevistadas 111 mães por meio de formulário padronizado contendo 15 perguntas relativas à associação do uso de fármacos pediátricos com a cárie dentária e aos cuidados com a higiene bucal. Foi usada a estatística descritiva e inferencial (Qui-quadrado de Pearson e exato de Fischer), com significância de 5 por cento. A maioria das mães tinha até 40 anos (77,4 por cento), ensino médio (30,6 por cento) e não trabalhava (50,5 por cento). A associação entre uso de medicamentos e cárie dental ou defeitos na estrutura dos dentes foi apontada por 35 (43,2 por cento) mães, das quais 33 (40,7 por cento) devido à presença de açúcar nas formulações. Apenas 32 (28,8 por cento) realizavam a higienização bucal da criança após a ingestão de medicamentos; 81,1 por cento (n=90) nunca receberam orientações quanto à importância desta prática. O tipo de ocupação e o grau de escolaridade materno não foram significativos nestas questões (p>0,05). Os medicamentos pediátricos podem trazer problemas para os dentes e alto percentual de mães não consegue estabelecer claramente a relação de causa e efeito existente em tal associação, portanto, é necessária maior conscientização das indústrias farmacêuticas para elaboração de medicamentos pediátricos sem a presença de sacarose.